Tuesday, July 05, 2011

Charging No-Show Fee For Missed Appointment?

I was watching this video clip with great interest. Charging no-show fees has always been a hotly debated and carefully contemplated topic even a decade ago when I worked as a certified medical assistant. So, I was curious what the video might tell me that's (not) new...

In watching the video I have to say I completely disagree! While the author says that the answer to charging patients for no-shows is a resounding yes to cover losses and as a form of negative reinforcement to teach patients NOT to do that, my response is a resounding no. Don't charge. It will simply alienate patients and at minimum, leave a sour taste in their mouth. Honest mistakes happen. We do get stuck in traffic, unforeseen things do come up and we get side-tracked, or we simply forget. Most patients intend to come as scheduled and many no-shows are honest mistakes. Even I, as a patient, have found myself caught up in unforeseen situations and I wound up calling the very last minute that I won't make it. In some States, no-show fees might not even be billable and when it comes to people who just toss the bill, collections probably cost more in time and effort than it is worth.

In my role as a certified medical assistant a few years ago, I have NEVER!!!!! Yes, NEEE-VER... seen a doctor sit and twiddle his/her thumbs to bridge the time gap from a no-show. You have to understand, appointments were scheduled tight, with so many patients per 15 or 20 minute time slots, fully aware that some patients might go over their allotted time in the exam room, while others might be right on the mark, or take up less time, so that in the end it would all even out.

No-show slots were a welcome break to direct the doctor's attention to phone messages attached to patient charts that had come in during the day and needed to be addressed so we could call the patients back with the doctor's instructions; furthermore gaps were filled with last minute sick calls and in the end they were a welcome brake to catch up with the daily grind. As the day progressed the doctor inadvertently almost always fell behind and patients who arrived on time for their appointment wound up sitting in the waiting room over 30 minutes, or more, just to be seen. A no-show gave us a little breathing room and in the end as the day progressed and closing time finally approached everybody was seen and cared for.

Knowing both sides of the coin, here is where I stand on this topic: if the doctor charges patients up to $125  for no-show then patients should charge the doctor the same amount for the time they are being kept in the waiting room beyond the scheduled appointment time. So, please!!!!! Let's just call it even, a win-win situation and give and take relationship between a trusting doctor and trusted patients.

In closing: I understand the old days of doctors in a horse buggy working for an apple and an egg are long gone. House calls in wind and weather any time a day are a thing of the past. The practice of medicine, while still noble and respected and an invaluable service to the community has become a for profit business. For more on medical practice management and medical billing questions visit our open and active forum.


John Sam Paul said...

I would agree, but would not take that far as to charge the doctor for delaying seeing me.

Anonymous said...

Medical assistants work very hard to accommodate all patients .I remember that we spent a good time of the morning calling patients to remind them of their appointment if they hadn’t confirmed. One office I worked in tried to minimize this by double booking their patients. All in all I think it is safe to say you wil always have no-shows, no matter what you do.

Danni R. said...

Patients that miss more than three or four appointments may be asked to seek their care elsewhere. Another blogger wrote her views on no show patients here:


Anonymous said...

I think it depends on the patient. If someone always attends their scheduled appointment and doesn't show up for one, I would let them slide, but someone who is a "no show" habitually, I would charge and then ask them to seek services elsewhere if it continues. If you can't make your appointment, call in and change it. It takes two seconds and opens up a slot for someone else. Besides, it's just bad manners not to show up.

Danni Gohemi said...

Matie Leaves tells me today on my facebook: "Went to the doc --- waited 45 minutes, ride left w/o me --- waited 2&1/2 hours --- exhausted, almost fell out of my wheelchair --- 4:30, haven't had breakfast yet. Can't figure out what to do about it. The End.